Multilevel Determinants of Circadian Factors and Sleep Disruption: Implications for Cardiometabolic Health Among African-Americans

昼夜节律因素和睡眠中断的多层次决定因素：对非裔美国人心脏代谢健康的影响

• 批准号: 10451280
• 负责人: Dayna Johnson
• 金额: $ 74.34万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10451280
• 关键词: Adult; Adverse effects; Affect; African American population; Air; Air Pollution; Apnea; Behavioral; Biochemical Markers; Biological Rhythm; Blood Glucose; Blood Pressure; Buffers; Cardiovascular Diseases; Cardiovascular system; Characteristics; Circadian Dysregulation; Circadian Rhythms; Circadian desynchrony; Clinic; Clinical; Controlled Environment; Data; Diabetes Mellitus; Disadvantaged; Electronics; Environment; Environmental Exposure; Environmental Risk Factor; Goals; Health; Home; Hour; Household; Housing; Hypertension; Individual; Inflammation; Intervention; Knowledge; Laboratory Study; Light; Link; Measurement; Measures; Melatonin; Metabolic dysfunction; Metabolism; Morbidity - disease rate; Neighborhoods; Noise; Obesity; Outcome; Physiological Processes; Pollution; Polysomnography; Population; Proxy; Psychosocial Factor; Psychosocial Stress; Research; Resources; Risk; Safety; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Social Environment; Socioeconomic Status; System; Technology; Testing; Time; Variant; actigraphy; arterial stiffness; base; cardiometabolism; cardiovascular health; circadian; cohort; coping; design; diaries; effective intervention; environmental adaptation; inflammatory marker; mortality; noise pollution; prevent; protective factors; resilience; sleep health; socioeconomics; socioenvironmental factor; urban area; ventilation

PROJECT SUMMARY/ABSTRACT Significance. Circadian and sleep disruption, and sleep disorders such as sleep apnea, are highly prevalent and associated with a host of adverse health outcomes including cardiovascular mortality and morbidity. African-Americans are disproportionately affected by disrupted/misaligned circadian rhythms, disrupted sleep and sleep apnea; which may be important, unique contributors to adverse CMB health in African-Americans. Reducing the burden of adverse cardiometabolic health in African-Americans may involve targeting both circadian rhythms and sleep. However, limited research exists on circadian rhythms in the natural environment of AAs, and there are major gaps in knowledge about the determinants of circadian and sleep disruption within African-Americans. We hypothesize that multilevel socio-environmental factors are drivers of circadian misalignment (a mismatch between the internal circadian system and behavioral or environmental cycles), which contribute to irregular sleep, and in turn disrupts physiologic processes such as blood pressure and metabolism in a socioeconomically diverse cohort of AAs. It is plausible that the hypothesized association differs by SES and individual resilience; thus, we will consider resilience as a protective factor that may mitigate the adverse effects of the environment. Approach. Leveraging resources from a well characterized cohort of African-Americans in Atlanta Georgia, we propose to use a repeated measures design to test the cumulative effects of real-time household- and neighborhood-level factors (e.g., socioeconomic status, light at night, noise, air pollution) on psychosocial factors, rigorously assessed circadian disruption/misalignment (including home dim light melatonin onset to measure internal endogenous biologic rhythms), sleep regularity (14-day actigraphy, diary) and apnea (in-home polysomnography) and relatedly, the impact of these measures on markers of CMB health in 400 AAs. To assess cardiometabolic health we will measure 24-hour blood pressure, arterial stiffness, and biochemical markers of inflammation and metabolic dysfunction. We will explore individual-level SES and resilience as effect modifiers of the hypothesized associations. Impact. The overarching aim of this R01 is to elucidate the largely unexplained high burden of adverse cardiometabolic health in African-Americans by specifically focusing on identifying the multilevel socio- environmental determinants of circadian and sleep disruption, and determining the relative impact of circadian and sleep disruption on markers of CMB health. This project will have a high impact, because it will identify salient socio-environmental factors (risk and protective) that contribute to circadian and sleep health in AAs, to inform culturally tailored multilevel interventions to reduce sleep and cardiovascular disparities.

项目摘要/摘要 意义重大。昼夜节律和睡眠紊乱，以及睡眠呼吸暂停等睡眠障碍， 普遍存在并与一系列不良健康后果有关，包括心血管死亡和 发病率。非洲裔美国人受到打乱/错位的昼夜节律的影响不成比例， 睡眠中断和睡眠呼吸暂停；这可能是导致CMB健康不良的重要而独特的因素 非裔美国人。减轻非裔美国人心脏代谢不良健康的负担可能包括 以昼夜节律和睡眠为目标。然而，目前对老年人昼夜节律的研究有限。 AAs的自然环境，对昼夜节律和AAs的决定因素的认识存在重大差距 非裔美国人的睡眠障碍。我们假设多层次的社会环境因素是 昼夜节律失调的驱动因素(内部昼夜节律系统与行为或 环境周期)，导致睡眠不规律，进而扰乱生理过程，如 社会经济不同的AA队列中的血压和新陈代谢。看似合理的是， 假设的关联性因SES和个人弹性而异；因此，我们将弹性视为一种 可以减轻环境不利影响的保护性因素。接近。利用资源 从佐治亚州亚特兰大一群特征良好的非裔美国人中，我们建议使用重复的 旨在测试实时家庭和邻居级别因素的累积影响的措施(例如， 社会经济状况、夜间照明、噪音、空气污染)对心理社会因素的影响，严格评估昼夜节律 干扰/错位(包括家庭暗光褪黑素发作，以测量内部内源性生物 节律)、睡眠规律(14天的活动记录、日记)和呼吸暂停(居家多导睡眠图)，以及与之相关的 这些措施对400名AAA人群CMB健康指标的影响。为了评估心脏代谢健康，我们将 测量24小时血压、动脉僵硬以及炎症和代谢的生化标记物 功能障碍。我们将探索个人层面的SES和Resilience作为假设的影响修饰符 联想。冲击力。本R01的主要目标是阐明在很大程度上无法解释的高负担 非裔美国人的不利心脏代谢健康通过特别关注识别多层次的社会- 昼夜节律和睡眠中断的环境决定因素，以及昼夜节律的相对影响 以及睡眠障碍对CMB健康指标的影响。这个项目将产生很大的影响，因为它将确定 显著的社会环境因素(风险和保护性)有助于AAS的昼夜节律和睡眠健康， 告知文化定制的多层次干预措施，以减少睡眠和心血管差异。